Interventions targeting geriatric frailty: A systemic review

Lee, Ping-Hsueh; Lee, Yow-Shan; Chan, Ding‐Cheng

doi:10.1016/j.jcgg.2012.04.001

Cited by 41 publications

(45 citation statements)

References 35 publications

(61 reference statements)

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“…For frailty as an interventional target, the small number of uses estimated in our study aligns with other research. A recent systematic review found only 11 interventional studies with frailty as an outcome (Lee et al, 2012); among these studies, 4 used the PFP (or a modified version) and 7 used less common frailty indicators. Also, two recent interventional studies measured frailty outcomes using the PFP (Fairhall et al, 2015; Cesari et al, 2014b).…”

Section: Discussionmentioning

confidence: 99%

Frailty assessment instruments: Systematic characterization of the uses and contexts of highly-cited instruments

Buta

Walston

Godino

et al. 2016

Ageing Research Reviews

668

468

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The medical syndrome of frailty is widely recognized, yet debate remains over how best to measure it in clinical and research settings. This study reviewed the frailty-related research literature by (a) comprehensively cataloging the wide array of instruments that have been utilized to measure frailty, and (b) systematically categorizing the different purposes and contexts of use for frailty instruments frequently cited in the research literature. We identified 67 frailty instruments total; of these, nine were highly-cited (≥200 citations). We randomly sampled and reviewed 545 English-language articles citing at least one highly-cited instrument. We estimated the total number of uses, and classified use into eight categories: risk assessment for adverse health outcomes (31% of all uses); etiological studies of frailty (22%); methodology studies (14%); biomarker studies (12%); inclusion/exclusion criteria (10%); estimating prevalence as primary goal (5%); clinical decision-making (2%); and interventional targeting (2%). The most common assessment context was observational studies of older community-dwelling adults. Physical Frailty Phenotype was the most used frailty instrument in the research literature, followed by the Deficit Accumulation Index and the Vulnerable Elders Survey. This study provides an empirical evaluation of the current uses of frailty instruments, which may be important to consider when selecting instruments for clinical or research purposes. We recommend careful consideration in the selection of a frailty instrument based on the intended purpose, domains captured, and how the instrument has been used in the past. Continued efforts are needed to study the validity and feasibility of these instruments.

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Section: Discussionmentioning

confidence: 99%

Frailty assessment instruments: Systematic characterization of the uses and contexts of highly-cited instruments

Buta

Walston

Godino

et al. 2016

Ageing Research Reviews

668

468

View full text Add to dashboard Cite

show abstract

“…Also, studies combining more than two domains were not in their scope of interest 23. Other reviews focused on other populations (eg, sarcopenia or obesity)22,24–26 or included studies that used no diagnostic tool to determine the frail population27,28 or used poor search criteria for (pre) frail participants (eg, only one keyword in database search) 29. Because of the limitations of existing reviews as well as to include information from recent studies, a systematic review was conducted, aiming to provide an overview of the effects of controlled multi-domain interventions in (pre)frail people aged ≥65 years on frailty status and score, cognition, muscle mass strength and power, and functional and social outcomes.…”

Section: Introductionmentioning

confidence: 99%

Effects of multi-domain interventions in (pre)frail elderly on frailty, functional, and cognitive status: a systematic review

Dedeyne¹,

Deschodt

Verschueren

et al. 2017

CIA

221

175

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BackgroundFrailty is an aging syndrome caused by exceeding a threshold of decline across multiple organ systems leading to a decreased resistance to stressors. Treatment for frailty focuses on multi-domain interventions to target multiple affected functions in order to decrease the adverse outcomes of frailty. No systematic reviews on the effectiveness of multi-domain interventions exist in a well-defined frail population.ObjectivesThis systematic review aimed to determine the effect of multi-domain compared to mono-domain interventions on frailty status and score, cognition, muscle mass, strength and power, functional and social outcomes in (pre)frail elderly (≥65 years). It included interventions targeting two or more domains (physical exercise, nutritional, pharmacological, psychological, or social interventions) in participants defined as (pre)frail by an operationalized frailty definition.MethodsThe databases PubMed, EMBASE, CINAHL, PEDro, CENTRAL, and the Cochrane Central register of Controlled Trials were searched from inception until September 14, 2016. Additional articles were searched by citation search, author search, and reference lists of relevant articles. The protocol for this review was registered on PROSPERO (CRD42016032905).ResultsTwelve studies were included, reporting a large diversity of interventions in terms of content, duration, and follow-up period. Overall, multi-domain interventions tended to be more effective than mono-domain interventions on frailty status or score, muscle mass and strength, and physical functioning. Results were inconclusive for cognitive, functional, and social outcomes. Physical exercise seems to play an essential role in the multi-domain intervention, whereby additional interventions can lead to further improvement (eg, nutritional intervention).ConclusionEvidence of beneficial effects of multi-domain compared to mono-domain interventions is limited but increasing. Additional studies are needed, focusing on a well-defined frail population and with specific attention to the design and the individual contribution of mono-domain interventions. This will contribute to the development of more effective interventions for frail elderly.

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“…Research to develop interventions targeting frailty is nascent [18, 19]. Key outcomes of interest have been quality of life, functional status (e.g., ability to perform activities of daily living), depression, and physical function.…”

Section: Introductionmentioning

confidence: 99%

Care recipients’ physical frailty is independently associated with subjective burden in informal caregivers in the community setting: a cross-sectional study

et al. 2016

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BackgroundPhysical frailty is associated with significant morbidity and mortality in community-dwelling older adults. Burden in informal caregivers of older adults causes significant physical and psychological distress. However, the relationship between these two clinical phenomena has not been extensively studied. This cross-sectional study evaluated the relationship between physical frailty of community-dwelling older adults attending an outpatient geriatric clinic and the subjective burden reported by their informal caregivers.MethodsWe measured the following characteristics of 45 patient-caregiver dyads attending an outpatient geriatric assessment clinic: Physical frailty using the Fried Frail Scale (FFS); self-reported independence in activities of daily living (ADL) using the Katz Index; clinical diagnosis of dementia; and subjective caregiver burden using the short 12-item version of the Zarit Burden Interview (ZBI). Multivariable linear regression was performed with FFS, Katz Index score, gender, age, and diagnosis of dementia as independent variables, and ZBI score as the dependent variable.ResultsOnly physical frailty significantly predicted caregiver burden (β = 8.98 95% confidence interval [CI]: 2.15, 15.82).ConclusionsPhysical frailty is independently associated with caregiver burden in a population of community-dwelling older adults. Despite limitations related to sample size and lack of data about caregiver characteristics, this study suggests that the relationship between physical frailty and caregiver burden merits further study.

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Interventions targeting geriatric frailty: A systemic review

Cited by 41 publications

References 35 publications

Frailty assessment instruments: Systematic characterization of the uses and contexts of highly-cited instruments

Frailty assessment instruments: Systematic characterization of the uses and contexts of highly-cited instruments

Effects of multi-domain interventions in (pre)frail elderly on frailty, functional, and cognitive status: a systematic review

Care recipients’ physical frailty is independently associated with subjective burden in informal caregivers in the community setting: a cross-sectional study

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